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Compliance

This section focuses on health care compliance and regulations – both national and state – including the ACA. It includes changes in health care law, regulation, and court decisions and their impact on health insurance professionals, employers, and individuals.

High Cost Of Health Care Is Top Concern As Employers Compete For Workers, Survey Finds

“Concerns about a recession and runaway inflation make it even more critical that employers are able to hire and keep top talent, and getting unreasonable health care costs under control can have a far-reaching impact on wages and ability to compete.”

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Pfizer’s COVID Cash Powers a ‘Marketing Machine’ on the Hunt for New Supernovas

The company has reaped nearly $100 billion from selling covid-19 vaccines and treatments to U.S. taxpayers and foreign governments. With that windfall, it plans to get richer, sinking the cash into developing and marketing potential blockbusters for conditions like migraines, ulcerative colitis, prostate cancer, sickle cell disease, and obesity.

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Millions Of Americans Have Health Insurance That Isn’t ‘Good Enough’

The open enrollment season for health insurance is gearing up at a time when more people in the United States have health insurance than ever before. Yet millions of Americans who enroll this fall still won’t be able to easily afford the health care they need or will be hit with medical bills they can’t pay. Why? ...

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Congressional Report Finds Health Care Sector ‘Uniquely Vulnerable’ To Cyber Attacks

Sen. Mark Warner (D-Va.), chairman of the Senate Intelligence Committee, released a report on Thursday outlining cybersecurity threats in the health care sector and ways the federal government can improve security standards in the industry. The report, which is divided into three sections, recommends that the federal government improve the country’s cybersecurity risk posture in the health care sector, help the private ...

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What A Divided Congress Could Mean For Healthcare In The Next Year

In the current Congress, Democrats were able to expand Affordable Care Act (ACA) subsidies and introduce drug price reforms, but experts say there could still be some progress on areas of common ground if Republicans take one or both chambers of Congress.

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Medicare Drug Price Negotiation: Key Decisions To Reach A “Fair Price”

Government negotiation of Medicare drug prices—even for a small set of older, single-source drugs—is a remarkable policy development. But how exactly will the government do it? The Inflation Reduction Act (IRA), signed into law August 16, contains an 86-page blueprint laying out which drugs are on the table, implementation timelines, “factors” to be considered, and rules of engagement ...

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Consolidated Appropriations Act Shifts More Power, Responsibility To Employers Next Year

The Consolidated Appropriations Act that passed this year will next year make self-insured employers the fiduciaries for the healthcare services that they purchase, which means they’ll have more say about quality and cost but also more responsibility. This portion of the approximately 5,600-page act hasn’t gotten as much attention as, for instance, the parts that guard against ...

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Healthcare Coverage Premiums Stable For Now, But Next Year Could See Hikes: Survey

Healthcare insurance premiums remained stable in 2022 compared to 2021 but might surge next year because of inflation and the demands of employees for better mental health coverage, according to the Kaiser Family Foundation’s “2022 Employer Health Benefits Survey.” “Demand” might be the right word, given the competition among employers for workers in a tight ...

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Self-Funded Plans Ignore The Consolidated Appropriations Act At Their Peril

It would be understandable if some leaders of self-funded benefits plans have not devoted ample time and attention to the Consolidated Appropriations Act (CAA), introduced into law in late 2021. Plan sponsors, including big and small companies, labor unions, and other organizations that provide health benefits, have had their hands full fending off challenges on ...

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DOL Gets Backlash On Its New ‘Gig Worker’ Rule, Extends Comment Period

After several business groups complained about the original timeline of the DOL’s proposed independent contractor rule, the agency is now allowing interested parties 15 additional days to comment on the rule. The U.S. Department of Labor extended the deadline from November 28 to December 13. The proposed rule, released on October 11 (and published in the ...

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